Provider Demographics
NPI:1932210820
Name:KHARABI, FEREIDOON (MD)
Entity Type:Individual
Prefix:DR
First Name:FEREIDOON
Middle Name:
Last Name:KHARABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 18245
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91416-8245
Mailing Address - Country:US
Mailing Address - Phone:818-776-9080
Mailing Address - Fax:
Practice Address - Street 1:16661 VENTURA BLVD.
Practice Address - Street 2:SUITE 714
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-776-9080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC377672084P0800X
CAC397672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry